• Mike Notohamiprodjo, Annie Horng, Bernhard Kuschel, Dominik Paul, Guobin Li, Jose G Raya, Maximilian F Reiser, and Christian Glaser.
• Department of Clinical Radiology, University Hospitals Munich, Marchioninistrasse 15, 81377 Munich, Germany. mike.notohamiprodjo@med.uni-muenchen.de
• Eur J Radiol. 2012 Nov 1; 81 (11): 3441-9.

ObjectivesTo evaluate the clinical usefulness of an optimized 3D-Fast-Spin-Echo-sequence (3D-SPACE) in combination with a 15-channel knee-coil for 3D-imaging of the knee at 3T.Methods15 volunteers and 50 consecutive patients were examined at 3 T with fat-saturated moderately T2-weighted 3D-SPACE (Voxel-size (VS): 0.6 mm×0.5 mm×0.5 mm/acquisition-time (AT) 10:44 min) using a 15-channel knee-coil. Flip angle optimization and radial k-space reordering were applied. Signal- and contrast-to-noise-ratios (SNR, CNR) were compared to non-optimized 3D-SPACE (8-channel knee-coil) and conventional 2D-FSE (VS: 0.4 mm×0.4 mm×3 mm/total AT: 12 min). Two radiologists independently rated depiction of internal knee structures and assessed detection and depiction of cartilage and meniscus abnormalities compared to conventional 2D-FSE-sequences. Sensitivity and specificity were calculated for a subgroup with arthroscopy as reference standard. Statistical analysis was performed with paired t-tests, confidence intervals and weighted-κ-coefficients.ResultsSNR and CNR particularly of fluid/cartilage of optimized 3D-SPACE were significantly higher (p<0.05) than of the non-optimized 3D-sequence and conventional 2D-sequence. Blurring and image inhomogeneity were reduced in the optimized sequence. The thin slice-thickness was beneficial for depiction of problematical anatomical structures such as meniscal roots. 3D-SPACE showed significantly higher diagnostic confidence (p<0.05) for diagnosis of cartilage lesions of the femoral trochlea. Overall sensitivity and specificity of 3D-SPACE and 2D-FSE for cartilage lesions was 82.3%/80.2% and 79.4%/84.2% and 100%/86.4% and 92.3%/81.8% for meniscus lesions.ConclusionsOptimized 3D-SPACE provides significantly higher signal and contrast compared to conventional 2D-FSE, particularly for fluid and cartilage, leading to improved diagnostic confidence, particularly in problematic areas, such as the femoral trochlea.Copyright © 2012 Elsevier Ireland Ltd. All rights reserved.

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